The surgeon’s estimation of fibrosis-sclerotic alteration in the thyroid. Part 2

Introduction. Fibrosclerotic changes in thyroid nodules are often the result of diagnostic and therapeutic manipulations that affect the structure and morphology of the nodes. The assessment of changes is ambiguous and depends on both the time factor and the initial structure of education. A decrease in the size and volume of cysts, nodules and tumors of the thyroid gland as a result of various diagnostic manipulations is a consequence of induced progressive fibrosis and sclerosis, which affect the assessment, course and outcome of the pathological process. The purpose of the study. To evaluate the variants and outcomes of fibrosclerotic changes in thyroid formations after diagnostic and therapeutic manipulations based on literature data. Methods. Search for literary sources in the databases E-library, PubMed, Scopus for the keywords "fibrosis", "sclerosis", "calcification", "hyalinosis", "puncture" in conjunction with the phrase "thyroid gland". Treatment results. The use of various puncture diagnostic methods, which allow obtaining material for a reliable morphological assessment of the processes occurring in the thyroid gland, is now unconditionally recognized by the scientific community of the world. In some cases, in addition to diagnosis, punctures have a therapeutic (diapeutic) effect aimed at reducing or completely eliminating the pathological focus in the organ. The removal of cellular material without aspiration, and especially with aspiration, is always accompanied by damage to both normal tissue and pathological foci of the thyroid gland with the development of alterative and sclerotic processes of varying severity. The changes can be not only minimal, but also significant, leading to gross structural changes, sometimes with complete replacement of the primary morphological structure of thyroid nodule formation by fibrosis. After performing diapeutic manipulations, the formation of fibrosis and sclerosis is an expected, predictable, therapeutic result. Conclusion. Today, puncture methods for thyroid nodules are the main components of diagnosis and choice of treatment tactics. However, in some cases, after previously performed repeated punctures and diapeutic interventions, it is difficult to obtain informative material for cytological examination. Fibrosis, hyalinosis and sclerosis that occur in the tissue and nodules of the thyroid gland at various times after diagnostic and therapeutic manipulations can significantly affect both the verification of the nature of the disease and the choice of therapeutic tactics.